I’m getting rid of my boobs before they get rid of me

March 3rd. A week from today.

That’s the day that my currently healthy boobs will take leave of my body. I’m still in disbelief that I’m about to do this, and I have the urge every day to cancel the upcoming surgery. But I know that logically I’m doing the smartest thing, hard as it is emotionally, and as hard as the surgery will be physically.

I was born with the BRCA2 gene mutation (which I blogged about last year, after I found out about it). Instead of a 3-ish% lifetime chance of getting breast cancer, I was born with about an 80-ish% chance of developing breast cancer in my lifetime. (Think Angelina Jolie, who was also born with a BRCA gene mutation and had a prophylactic mastectomy.)

(Thanks, rosalarian.tumblr.com.)

So far, my mammograms and recent breast MRIs have been clear, but it’s likely just a matter of time before I’d be faced with a breast cancer diagnosis. And if that were the case, I’d have to go through this surgery AND chemo/radiation. No thanks!

I’m 64. That means a few things in regard to my mastectomy situation.

One, I’ve already worked through a big chunk of that 80+% chance of getting breast cancer, so my chance at this point is about 35%. I go back and forth, from thinking that 35% is perfectly tolerable and I should just take the risk, to ‘no way; that’s still a huge chance of breast cancer,’ and back again. Round and round and round. It’s mentally and emotionally exhausting!

Two, I’ll be starting Medicare on November 1st of this year, the month in which I’ll turn 65. I was hoping that Medicare would be optional, but for me, it’s not. On the day that I’m eligible for Medicare, my other coverage is hugely affected. Long story short, I will be starting Medicare on November 1st of this year and MEDICARE WON’T COVER PREVENTATIVE SURGERIES. Nope, they want to wait until you actually get cancer, and only THEN would a mastectomy be covered! Yes, this is insane, but there’s nothing I can do about it.

So my hands (or rather, my boobs) have been forced. If I’m gonna do this, I need to do it now. The reconstruction process involves numerous surgeries, so I need to allow time for all this to happen before I begin Medicare.

There are three basic options after a mastectomy – “going flat,” flap reconstruction (which is harvesting fat from other locations on the body and transferring it to the breast… a very long and complicated microsurgery with a long, complex recovery), and implants. Because of my abdominoplasty thirty years ago to repair damage from my twin pregnancy, I’m not a candidate for the most common (DIEP) flap reconstruction and, although I’ve considered it, I’ve decided not to “go flat.” That leaves “gummy bear” silicone implants. This is the one I explored during my appointment with the plastic surgeon. I kinda like the shape, and the smaller size!

It’ll be months, though, before the gummy will be in my body. Expanders will be placed next week during the mastectomy surgery, and then those will be filled a bit at a time over the next couple of weeks, until I’m at my desired size (smaller). At that point, I’ll undergo an additional (“exchange”) surgery to replace the expanders (which I hear are awful) with the final gummy implants. Fun. (Not.)

Kat’s wedding will take place on May the fourth (of course, Star Wars fans that she and Ian are!) and will be off the grid at Danny’s prospecting claims, where they got engaged (including a very bumpy dirt road – gah!) in California, so we’ll need to work that into the scheduling.

Am I ready? NO. But I don’t know how I ever can really be ready to basically amputate a body part that’s integral to who I am. I’ve chosen to look at it this way: my boobs have nourished four healthy children and have served me well. Now they are trying to (or will likely try to) kill me and they need to go. That’s my logical approach, anyway.

My not-so-logical approach consists of feelings of sadness, loss, and fear.

I’ll let you know how it goes…